Category: Blog

Imagine buying a plane ticket, but the fare only covers your seat, the fuel, the gate attendant, and the peanuts. You have to pay the pilot separately. You are sitting on the plane and, unbeknownst to you, the pilot scheduled to fly your plane is delayed and a pilot from another airline takes over. Because […]

The rules of other consumer commerce sectors somehow do not apply to medical billing. Stop and think about that for a moment. It’s easier to make sense of how much we spend for goods and services such as groceries, clothing, and gasoline because we know how much it costs up front. No smoke and mirrors. […]

For 2019 and 2020, we will see no changes to our outpatient, office-based evaluation and management (E&M) services, but things will change come 2021 – that according to the E&M Final Rule released Thursday by the Centers for Medicare & Medicaid Services (CMS). Since 2004, CMS has stated through the Claims Processing Manual that medical […]

Over the last few years, healthcare has shifted from a standardized, product-centric experience to one that is more personalized. Patients now have access to more information on providers than ever, meaning they have more choice when selecting care they feel will best meet their unique needs. At the same time, patients are taking on more […]

MAs are taking advantage of excessive denials to reduce payments to providers. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently found that between 2014 and 2016, a total of 75 percent of all appealed Medicare Advantage (MAs) denials were overturned, equivalent to roughly 216,000 denials a year. I […]

There are numerous patient engagement strategies aimed at improving care. What are the outcomes that show these solutions are working? Patient engagement affects every patient interaction across the care continuum. Accordingly, the outcomes that you can expect will come from every area of the organization. When refining targeted outcomes, let metrics be your guide. Measurement […]

Nearly all healthcare decision makers recently surveyed by KLAS said their organization saw financial gains after implementing a clinical documentation improvement solution. Provider organizations are seeing financial improvements after implementing clinical documentation improvement (CDI) solutions, a recent KLAS survey shows. Revenue improved for about 53 percent of healthcare executives, medical records directors and managers, and […]

Loading up MIPS reporting on one of three performance categories can help eligible clinicians prevent a negative payment adjustment in 2020, the AMA found. Eligible clinicians can avoid a financial penalty under the Merit-Based Incentive Payment System (MIPS) in 2020 by focusing their reporting on one of three performance categories: Quality, Improvement Activities, or Promoting […]

Hurricane Florence, described as an “extremely dangerous” Category 4 hurricane, was headed for the southern North Carolina coast. In a written statement to RACmonitor, Atrium Health, formerly Carolinas Healthcare System, said that its teams “remain focused on the safety of our employees, the coordination of resources across affected healthcare facilities, and most importantly, our commitment […]